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. , `. <br /> Duct Seal Affidavit <br /> Company �.(/aK,v l/��.S N����, 9�"�o v L�G� License# �� C.U S� � 3� <br /> Address_��ya � (�IXL/,P �� iC� Permitt� �� <br /> �P4��G�1� � � � ` �� � J n � � .��'e 5� <br /> .� "3 .� � ( / 1 <br /> � ( �c/ �� v <br /> ��-3 � <br /> � <br /> z e � � �'; ��� �� <br /> � <br /> � Y <br /> �f i"�� r �n�v C"aff''iant,hereby affirm that I am the duly licensed contrador of record for the above <br /> referenced permit,that all of the forgoing information is true and accurate,and that the duct sealing at the above <br /> referenced address has been completed in accordance with atl applicable codes and standards. <br /> Contractors Name(printed) � � � <br /> � o���i�r o tOa f�'� oate 6 � / � l :� <br /> Si nature �� /�" � <br /> 6 <br /> State of �pY.�IG <br /> County of a,hc� -- <br /> On this "�_day of 5�}. ��i,� <br /> before me personally appeared - ,•�`a�P'�•. EMILY FUNNELI <br /> �T�m O'�nQV_(� =_°�� u.`��s Notary Public-State of Florida <br /> to m�known to be the�erson who executed the �,* •�' My Comm.Expires May 6,2015 <br /> foregoing instfument,and acknpwleclgedthat he ':',�F����d�;:'� Commission N EE 89389 <br /> executed the sa e as his ree aCt arld deed. Bonded Through National Notary Assn. <br /> SEAL(signedj ` <br /> �IOTARIP 6+UQLtC -- <br />